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Published on: August 22, 2022
Prevalence of Pulp Stones on Panoramic Radiographs in Patients with Chronic Systemic Diseases: A Cross-sectional
Shamimul Hasan1, Tarun Sharma1, Shazina Saeed2
1Department of Oral Medicine and Radiology, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India.
Introduction:
Pulp stones (PS) are incidental, mostly asymptomatic, radiographic findings that may hinder endodontic therapy. They are observed as radiopaque aggregates within coronal or radicular pulp tissue on intraoral periapical, bite-wing, panoramic radiographs and cone-beam computed tomography images. This study aimed to evaluate PS prevalence in patients with cardiovascular disease (CVD), diabetes mellitus (DM), and chronic periodontitis (CP) as compared with controls, as a function of age and sex.
Material And Methods:
This cross-sectional study included 200 subjects: 50 healthy controls, and 50 patients each with CVD, DM, and CP. All participants underwent digital panoramic radiograph (orthopantomogram) (OPG) evaluation for the presence/absence, number, and location of PS.
Results:
Significant differences in PS prevalence were observed among the groups (P<0.01), with CVD patients showing the highest prevalence. Older individuals (>50 years) and first molars were most frequently affected. The maxillary arch showed a significantly higher prevalence than the mandible (odds ratio [OR]=1.45; 95% CI 1.22-1.72). The strongest risk factor was CVD (OR=7.38; 95% CI 5.20-10.47), followed by DM (OR=4.18; 95% CI 2.91-5.99) and CP (OR=4.16; 95% CI 2.88-6.00). Age was significantly associated with PS, while sex showed no association.
Conclusion:
The presence of PS, even among healthy controls, may serve as an adjunctive radiographic marker and could also alert dental practitioners to the possibility of underlying systemic disease.
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